Objective. To investigate the association between early perihematomal edema (PHE) expansion and functional outcome in patients with intracerebral hemorrhage (ICH). Methods. Patients with ICH who underwent initial computed tomography (CT) scans within 6 hours after the onset of symptoms and follow-up CT scans within hours were included. Absolute PHE increase was defined as the absolute increase in PHE volume from baseline to 24 hours. A receiver-operating characteristic (ROC) curve was generated to determine the cutoff value for early PHE expansion, which was operationally defined as an absolute increase in PHE volume of >6 mL. The outcome of interest was 3-month poor outcome defined as modified Rankin scale score of ≥4. A multivariable logistic regression procedure was used to assess the association between early PHE expansion and outcome after ICH. Results. In 233 patients with ICH, 89 (38.2%) patients had poor outcome at 3-month follow-up. Early PHE expansion was observed in 56 of 233 (24.0%) patients. Patients with early PHE expansion were more likely to have poor functional outcome than those without (43.8% vs. 11.8%, ). After adjusting for age, admission systolic blood pressure, admission Glasgow Coma Scale score, baseline ICH volume and the presence of intraventricular hemorrhage, and time from onset to CT, early PHE expansion was associated with poor outcome (adjusted odds ratio, 4.25; 95% confidence interval, 1.70–10.60; ). Conclusions. The early PHE expansion was not uncommon in patients with ICH and was correlated with poor outcome following ICH.

中文翻译：

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早期血肿周围水肿扩大：定义、意义和与脑出血后结果的关联

客观。研究脑出血 (ICH) 患者早期血肿周围水肿 (PHE) 扩张与功能预后之间的关系。方法。在症状出现后 6 小时内接受初始计算机断层扫描 (CT) 扫描的 ICH 患者，并在 6 小时内接受 CT 扫描小时包括在内。绝对 PHE 增加定义为从基线到 24 小时 PHE 体积的绝对增加。生成接受者操作特征 (ROC) 曲线以确定早期 PHE 扩张的截止值，其在操作上定义为 PHE 体积的绝对增加 > 6 mL。感兴趣的结果是 3 个月的不良结果，定义为改良 Rankin 量表评分≥4。使用多变量逻辑回归程序来评估早期 PHE 扩张与 ICH 后结果之间的关联。结果. 在 233 名 ICH 患者中，89 名（38.2%）患者在 3 个月的随访中结果不佳。233 名患者中有 56 名（24.0%）观察到早期 PHE 扩大。早期 PHE 扩张的患者比未扩张的患者更可能出现较差的功能结果（43.8% 对 11.8%，）。在调整了年龄、入院收缩压、入院 Glasgow 昏迷评分、基线 ICH 体积和脑室内出血的存在以及从发病到 CT 的时间后，早期 PHE 扩张与不良结果相关（调整后的比值比，4.25；95%置信区间，1.70–10.60；）。 结论。早期 PHE 扩大在 ICH 患者中并不少见，并且与 ICH 后的不良结果相关。